An adaptable patient-centric electronic health record system for personalized home care

The increasing ageing of population and the prevalence of chronic diseases push the adoption of home care processes that can delay or discontinue the access to hospitalization and specialized structures. To this end, ICT plays a crucial enabling role providing a growing ecosystem of diagnostic and monitoring devices, communication networks, and information management applications. As a part of this, advanced software architectures provide means for effective integration and management of clinical data produced by a variety of sources and accessed by a variety of actors involved in the care process. We describe the software architecture of an Electronic Health Record (EHR) system that exploits the Reflection architectural pattern to allow agile tailoring for the needs of different medical specialties. We then show how this adaptability can be further exploited to face a number of challenging requirements posed by the context of home care, including: patient-centric personalization of the record structure; user-adapted content presentation; automated support for compliance verification; systems medicine connection of clinical observations pertaining to different specialties; integration of users observations and data streams acquired from remote monitoring devices.